Effect of Community-Based Intervention Using Depression Screening on Elderly Suicide Risk: a Meta-Analysis of the Evidence From Japan

A systematic review was undertaken to quantify the effect of community-based depression screening (CDS) with follow-up on the completed suicide risk for residents aged 65 and over. Five quasi-experimental studies in Japanese regions with high suicide rates were included in the meta-analysis. Combined incidence rate ratios (95% confidence intervals) by the MantelÐHaenszel method and by the DerSimonianÐLaird method in two homogenous studies implementing the follow-up conducted by psychiatrists were 0.30 (0.13Ð0.68) and 0.33 (0.14Ð0.80) in men, and 0.33 (0.19Ð0.58) and 0.33 (0.19Ð0.60) in women, respectively; and those in three homogenous studies implementing the follow-up conducted by general practitioners were 0.73 (0.45Ð1.18) and 0.74 (0.45Ð1.23) in men, and 0.36 (0.21Ð0.60) and 0.39 (0.22Ð0.66) in women, respectively. There are very few studies included, however, to demonstrate an association between CDS and the reduced risk, suggesting gender difference in the effectiveness.